PARIS – When France finalized a complex blueprint for vaccinating its population against the coronavirus in December, the government tacitly gave millions of dollars in contracts to consulting giant McKinsey & Company.
The contracts, which were not originally announced publicly, were designed to help millions of tiny bottles of vaccine quickly get to distribution points for nursing homes, healthcare providers and the elderly. Additional contracts were hastily placed with other consultants, including Accenture and two France-based companies.
But within a few weeks, France’s vaccination campaign was mocked for being far too slow. At the beginning of January, according to the health minister, France had only vaccinated “several thousand people”, compared with 230,000 in Germany and more than 110,000 in Italy.
When the consulting contracts came to light, McKinsey became a magnet for controversy in a country where an elite civil service is expected to manage public affairs and private sector involvement is viewed with caution.
The contracts – a total of 11 million euros ($ 13.3 million), of which 4 million went to McKinsey – were approved by a parliamentary committee last week. President Emmanuel Macron’s administration, which has been under fire for months for stumbling in dealing with the pandemic, has had to admit that it has turned to outside consulting firms for help managing the response.
On Wednesday, 18 lawmakers from the Conservative Les Républicains party sent a letter to President Macron asking for further answers as to why McKinsey, an advisor to businesses and governments around the world, was hired to assist French authorities with the launch of the The vaccine.
The letter cited McKinsey’s recent agreement to pay nearly $ 600 million to US authorities to settle claims that they contributed to the “devastating opioid crisis” as a concern for their involvement in French health issues.
A McKinsey spokesman declined to comment.
France is hardly the only European country that involves the private sector in public affairs. Governments from Britain to Greece have tapped consulting firms for years to streamline bureaucracy. As governments have been downsized, many of them have become more dependent on outside contractors for outside public services.
Mr. Macron, a former investment banker, took office and promised to run one of Europe’s largest governments more efficiently. The response to the coronavirus has been criticized in France as the opposite, with repeated lockdowns, supply shortages and the failure to put in place a critical triptych of testing, tracking and isolation last summer. The missteps offered McKinsey and other advisors a new opportunity to intervene.
Nobody accuses McKinsey of wrongdoing. The company has strategically rolled out its pandemic advisory services in a number of other countries around the world, including the UK, where it has contracts to advise the Covid-19 Task Force and determine the National Health Service’s tests worth £ 1.1 million (approx $ 1.5 million) has completed capacity. In the United States, the company has won over $ 100 million worth of Covid-19 contracts from federal, state and city authorities.
In France, health authorities have signed a contract with McKinsey and other consultants to assist in the implementation of the vaccine rollout, scheduled for December 28, after the European Union signed a late contract with pharmaceutical companies in mid-November for millions of vaccine doses for member countries.
Health Minister Olivier Véran defended the decision after the contracts first reported by Politico became known in January.
“It is not the first time that we have brought in private partners,” he told the French Senate. He added that McKinsey “helped with the practical, operational, and logistical challenges of our vaccination strategy” but played no part in policy decisions.
Apr. 21, 2021, 6:38 p.m. ET
McKinsey works primarily in France for corporate clients. Even so, McKinsey has had close ties with a number of French governments, and some officials have previously worked for McKinsey.
In recent years, France has increased the use of consultants and created special budgets that the agencies can use to bring in external consultants if necessary. In 2018, McKinsey was selected as one of several consultants who can be hired by French agencies under a pool agreement of over 100 million euros. This meant that each of the agencies could choose one of the companies without having to get quotes for work.
The December contracts and another contract in mid-January totaling EUR 4 million originated from this combined agreement. McKinsey was asked to help define the distribution channels for the Pfizer and Moderna vaccines, which must be kept at temperatures as low as minus 80 degrees Celsius during transport and storage. The company would compare France’s performance with other European countries. McKinsey experts would also help coordinate a task force on vaccination of officials from numerous agencies, with some decision-making chains involving up to 50 agencies.
Additional contracts provided for Accenture, the global information technology consultant, to implement the campaign’s surveillance systems and two French consultants, Citwell and JLL, to help with “logistical support and vaccine distribution.”
The government’s strategy focused on delivering the vaccines to 1,000 distribution points in France, from where the cans would be shipped in supercooled trucks to nursing homes, clinics and local mayor’s offices. Local distribution was seen as a way to overcome the caution of up to 40 percent of the population about vaccination.
In Germany, the program was simpler: the authorities decided to give the vaccine in 400 regional centers.
France had a million doses of vaccine in hand by the first week of January, but the delay in getting them into people’s arms became public knowledge. The campaign continued to lag as Pfizer and Moderna temporarily slowed additional supplies.
The pace has increased recently. More than three million of France’s 67 million people have now received at least one dose of vaccine and over 923,000 have been fully vaccinated. According to a New York Times database, France still lags behind neighbors like Germany and Italy with 4.7 doses per 100 people.
For critics of government strategy, performance raises questions about the value that consultants add to the process.
Frédéric Pierru, sociologist and researcher at the French National Center for Scientific Research, has worked in French hospitals and regional health authorities for 15 years, studying the impact of consulting firms brought in to improve efficiency. He said companies tended to import operating models that were used in other industries that weren’t always effective for public health.
“After that, the government doesn’t go back to assess whether what the consulting firms did well worked well or not,” Pierru said. “It’s too early to say if McKinsey and others are adding value to this campaign,” he added. “But I think we’ll never really know.”
The legislature is pushing for more information.
Véronique Louwagie, a MEP from Les Républicains and rapporteur for the French parliament on the national health budget, informed the Finance Committee that numerous additional private contracts to combat the pandemic have been awarded by other agencies, the amounts of which are not public.
While the cost may pale in comparison to the billions France spends in support of the economy, “What bothers me is that the government is not transparent,” Ms. Louwagie said in an interview.
The bigger concern, she said, is whether the government’s apparently growing reliance on advisers will replace the expertise that officials previously provided.
“I’m not necessarily shocked that the government is bringing in consulting firms,” said Ms. Louwagie. “But in France this is evidence of the loss of savoir faire and expertise in health administration to deal with the crisis,” she said.
“When a country’s health department needs the help of counselors,” she added, “we have to ask ourselves why.”